Department of Medical Physics, Fondazione IRCCS San Matteo Hospital, Pavia, Italy.
Spine (Phila Pa 1976). 2010 Jun 1;35(13):1304-6. doi: 10.1097/BRS.0b013e3181c3e880.
We studied the radiation doses to which patients were exposed during 17 vertebroplasty operations.
The radiation doses during vertebroplasty were measured to determine maximum skin dose (MSD), a measure of the likelihood of radiation-induced skin effects.
Vertebroplasty is performed with use of fluoroscopic guidance for needle placement and to monitor bone cement injection. This procedure requires relatively long duration of fluoroscopic guidance, and so, it demands dose measurements for patients.
From May 2006 to April 2008, 16 patients (7 men and 9 women; mean age 70.19 years, range 30-87 years) underwent a total of 17 vertebroplasty procedures. Total dose-area product (DAP), duration of fluoroscopy, and the parameters for anteroposterior (AP) and lateral (LAT) fluoroscopic and fluorography projections were recorded for each procedure. Gafchromic films were placed on the patients' skin to measure entrance surface dose and to evaluate the MSD.
The MSD and DAP were higher in the LAT plane than in the AP plane. These results were expected because the fluoroscopy time was longer, and the number of fluorography runs was higher in the LAT plane than in the AP plane.The MSD values for the AP plane ranged between 0.184 Gy and 1.834 Gy, whereas those for the LAT plane ranged between 0.417 Gy and 2.362 Gy. The frequency distribution of values for both planes showed that most MSD values were in the range of 0 to 0.5 Gy and 0.5 to 1 Gy for the AP plane and 0.5 to 1 Gy and 1 to 1.5 Gy for the LAT plane. There was great variability in the MSD at each value for the parameters among individual instances.
When evaluating the MSD to a patient, a distinction should be made between AP and LAT projections, because an overall mean MSD value underestimates the contribution of x-ray absorption on the LAT plane. The use of radiochromic films to estimate radiation damage to the skin has been shown to have the limitation of relying on DAP values only.
我们研究了 17 例椎体成形术中患者所接受的辐射剂量。
测量椎体成形术中的辐射剂量，以确定最大皮肤剂量（MSD），这是衡量辐射引起皮肤效应可能性的指标。
椎体成形术是在透视引导下进行的，用于放置针头并监测骨水泥注射。该过程需要相对较长时间的透视引导，因此需要对患者进行剂量测量。
从 2006 年 5 月至 2008 年 4 月，16 名患者（7 名男性和 9 名女性；平均年龄 70.19 岁，范围 30-87 岁）共接受了 17 例椎体成形术。记录每个手术的总剂量面积乘积（DAP）、透视时间以及前后（AP）和侧位（LAT）透视和荧光透视投影的参数。将 Gafchromic 胶片放置在患者皮肤上，以测量入射表面剂量并评估 MSD。
LAT 平面的 MSD 和 DAP 高于 AP 平面。这是意料之中的，因为 LAT 平面的透视时间更长，并且荧光透视次数也更多。AP 平面的 MSD 值范围在 0.184 Gy 至 1.834 Gy 之间，而 LAT 平面的 MSD 值范围在 0.417 Gy 至 2.362 Gy 之间。两个平面的 MSD 值的频率分布表明，大多数 MSD 值在 0 至 0.5 Gy 和 0.5 至 1 Gy 范围内，而对于 AP 平面，在 0.5 至 1 Gy 和 1 至 1.5 Gy 范围内，而对于 LAT 平面，在 0.5 至 1 Gy 和 1 至 1.5 Gy 范围内。在每个参数的 MSD 值中，个体实例之间存在很大的差异。
在评估患者的 MSD 时，应区分 AP 和 LAT 投影，因为总体平均 MSD 值低估了 LAT 平面上 X 射线吸收的贡献。已经证明，使用放射性色膜来估计皮肤的辐射损伤具有仅依赖于 DAP 值的局限性。
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